Organization
BODNER AND BODNER- BRANFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL GEREON BODNER D.D.S. (GENERAL PARTNER)
(203) 481-2509
Entity
Organization
Contact information
Practice address
365 EAST MAIN STREET, SUITE #2, BRANFORD, CT 06405-2913
(203) 481-2509
Mailing address
365 EAST MAIN STREET, SUITE #2, BRANFORD, CT 06405-2913
(203) 481-2509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7086
CT
Other
Enumeration date
06/15/2015
Last updated
06/18/2015
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